Memory Care in New Mexico

Table of Contents

Memory Care in New Mexico

Table of Contents

• The Cost of Memory Care in New Mexico
• New Mexico Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in New Mexico?
• More Ways To Pay for Memory Care in New Mexico
• Memory Care Laws and Regulations in New Mexico
• Free and Low-Cost Resources for Seniors in New Mexico
• New Mexico COVID-19 Rules for Memory Care Facilities

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When figuring out how to pay for memory care, you first need to understand how much it will cost for your loved one to move to a quality community. As costs continue to rise, it's vital to have the latest details when planning for elderly care costs. In order to shed light on the impact of inflation on senior living costs, MemoryCare.com has gathered cost information from its network of over 75,000 senior living communities. These prices are based on the cost of Memory Care in New Mexico and 3 other cities in New Mexico.

How Inflation Has Impacted the Cost of Memory Care in New Mexico

Inflation has caused many expenses to increase, including senior care. In New Mexico, memory care costs across the state saw a 5.5% increase between 2022 and 2023. Fortunately, it's lower than the 10.5% increase observed on a national level. Many neighboring states also saw a greater impact, with rates rising 15% in Arizona and 12% in Colorado. 

Another bump in costs is expected in 2024. Rates in New Mexico are projected to hit $5,553, while rates in Arizona and Colorado are estimated to reach $6,209 and $6,382, respectively. This emphasizes the importance of planning ahead for senior care.

Memory Care Costs in New Mexico's Top Cities

Memory care costs can vary across different cities in New Mexico. Among them, Santa Fe has very affordable rates at $4,739. Costs in Rio Ranch also fall below the state median, averaging $4,835 per month. Meanwhile, Albuquerque, the state's largest city, sees a slightly higher average rate of $5,488. Interestingly, Tucson, AZ, a neighboring city, offers memory care at a lower cost of $4,181, making it a potential alternative for cost-conscious individuals seeking dementia care.

The Cost of Other Types of Senior Living

The cost of various senior care options shows distinct differences. Independent living is the most cost-effective at $2,961, catering to self-sufficient seniors. Memory care is priced higher at $5,214 due to the specialized care it offers for seniors with cognitive issues. For $4,185, assisted living provides a mid-range option, offering support while allowing some independence. Factors such as personalized programming and the level of assistance provided contribute to these variations in senior living costs.

In New Mexico, memory care services are covered by Centennial Care, the state’s Medicaid 1115 waiver and managed care demonstration program. New Mexico’s Medicaid program offers multiple pathways towards Medicaid eligibility and covers a variety of services that are provided in home and community-based settings, including memory care facilities.

• Who Is Eligible: Centennial Care is available to residents of the state of New Mexico. They must also be a U.S. national, citizen, permanent resident or legal alien, have a need for health care/insurance assistance and have a financial situation that would be characterized as low or very low income.
• How To Apply: You can learn more about Medicaid and other available benefits by contacting the state’s Aging and Disability Resource Center at (800) 432-2080 or the Human Services Department at (800) 283-4465.

Centennial Care

New Mexico's Medicaid managed care program is called Centennial Care, and memory care services are delivered via the Community Benefit. This program provides long-term care services for seniors in residential settings. It has a self-directed care option in which participants can choose their own care providers. In some cases, this could include eligible family members. While the program doesn’t directly pay for assisted living with memory care, it covers some specialized services received in an assisted living setting, including adult day health care, respite care, personal care assistance, private duty nursing and personal emergency response systems.

• Who Is Eligible: To be eligible for the Community Benefit, applicants must be qualified to receive services under Centennial Care. Generally speaking, an applicant must be a U.S. citizen, national, legal alien or permanent resident, and they must be a permanent resident of New Mexico. As of 2020, the annual income limit is $30,276 for a single applicant and $60,552 for a two-person household.
• How To Apply: Those who are interested in enrolling in the Community Benefit should apply online through the Centennial Care website or contact the state’s Human Services Department at (800) 283-4465. Alternatively, qualifying seniors may receive in-person assistance and submit an application at their nearest NM Human Services Department field office. There are a limited number of Community Benefit placements in New Mexico.

Medicaid Eligibility for Seniors in New Mexico 

Any income that an applicant receives is counted towards Medicaid’s income limit. This means income from any source, including employment wages, alimony payments, pension payments, Social Security Disability Insurance, Social Security retirement benefits, IRA withdrawals and stock dividends.

2022 Medicaid Income Limits for Seniors in New Mexico

Other eligibility requirements include:

• Residency in the state of New Mexico
• U.S. national, citizen, permanent resident or legal alien status
• Need for health care/insurance assistance
• Financial situation characterized as low income

How To Get Help Applying for Medicaid in New Mexico

New Mexico has online and in-person tools available to help seniors who are applying for Medicaid. These include call centers, chat lines, in-person counseling and other resources.

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It's best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.

Memory Care Regulation

In New Mexico, memory care is provided in assisted living facilities for adults. These facilities are licensed and regulated by the New Mexico Department of Health.

In addition to the standard requirements that are met by all assisted living facilities in the state, those that offer memory care services must meet additional conditions. These include requirements relating to care coordination, staffing, training individualized service plans, assessments and re-evaluations, documentation, security and resident rights.

Facility Scope of Care

Memory care facilities in New Mexico are required to provide supervision and assistance to residents as necessary with specified nursing services, including:

• Medication administration or supervising self-administration
• Activities of daily living
• Recreational and social activities
• Laundry and housekeeping
• Transportation
• Around-the-clock comprehensive nursing services are not provided.

Memory care facilities are required to provide three nutritionally balanced meals and evening snacks that are in keeping with recommended daily dietary guidelines.

Admissions Requirements

Prior to admitting a prospective resident with dementia, the assisted living facility must conduct a pre-admission assessment to determine whether the secured environment is needed or if a less restrictive alternative is appropriate. Memory care facilities in New Mexico can accommodate a wide range of residents, but there are some restrictions in place as well. This table outlines who may and may not be admitted or retained.

Residents Who May Be Admitted

Older adults and people who:

• Have Alzheimer’s disease or dementia
• Have traumatic brain injuries
• Have developmental or physical disabilities
• Are receiving hospice care

Residents Who May NOT Be Admitted

Those who:

• Require 24-hour continuous nursing care
• Are ventilator dependent
• Have Stage III or IV pressure sores
• Require physical or chemical restraints
• Require intravenous therapy or injections

Care Plan Requirements

Memory care facilities must provide individualized service plans for prospective residents prior to admission to ensure that the facility is equipped to meet their needs. The service plan must provide an outline of the services that will be provided, including when, how and by whom. Residents must be reassessed every six months or after a significant change in their health or abilities.

Residents may contract with third-party agencies, including hospice agencies. The memory care facility must coordinate care provided within the building by these third-party agencies.

Medication Management Requirements

Residents may self-administer their medication with the approval of their physician. If they don’t have physician approval, then they can self-administer medications with the assistance of a facility staff member who has successfully completed a state-approved program in medication administration assistance. Medications may only be administered by a relative of the resident, a physician, a physician extender or a licensed nurse.

Staff members who assist with medication self-administration are responsible for understanding the potential interactions and side effects that may occur with a given medication. Memory care facilities must have a consulting pharmacist on staff who reviews medication lists on a quarterly basis to ensure that records and orders are accurate. The pharmacist must also ensure that the facility is properly storing, labeling, documenting and disposing of medications in accordance with the requirements of the state’s Board of Pharmacy.

Facility Requirements

In New Mexico, apartment-style units in assisted living facilities, including those that offer memory care, are not required. Units may be single or double occupancy. Single occupancy units must be at least 100 square feet, and double occupancy units must have at least 80 square feet per resident, excluding storage space. At least one toilet, sink and bath or shower must be provided for every eight residents.

Memory care facilities must have a secured environment to prevent residents from wandering. This is described by the state as any locked area with fences or doors that restrict access through the use of alarms. Facilities must also have secured outdoor areas for residents to use throughout the year.

Staffing Requirements

New Mexico provides specific guidelines regarding staffing requirements and ratios to ensure that residents receive adequate care. All memory care facilities must have an administrator who is responsible for daily operations. They must also have a sufficient number of direct care staff who are specially trained to meet residents’ needs, and at least one staff member must be awake at all times. The facility must have a licensed nurse who provides medication administration and a licensed nurse or physician extender who reviews health evaluations and ISPs.

Direct care staff must complete 16 hours of supervised training before providing unsupervised care, along with 12 hours of training annually. This training includes fire safety, first aid, resident rights and confidentiality, reporting requirements for abuse, infection control and transportation safety. They must also have at least 12 hours of annual dementia-related training.

Medicaid Policy

In New Mexico, memory care services are covered by Centennial Care, the state’s Medicaid 1115 waiver managed care demonstration program.

Reporting Abuse

Family members, seniors and the general public have two avenues for reporting suspected or observed abuse, exploitation or neglect. They may call the toll-free Health Facility Complaints hotline at 1-800-752-8649. Alternatively, they may print a Health Facility Consumer Complaint Form and fax or mail it to the provided number or address.

Health facilities are required to report all incidents of abuse, neglect, exploitation, injuries of unknown origin or cases of death where abuse or neglect is suspected. Reports are to be made through the state’s Health Facility Reporting System.

In New Mexico, there is an abundance of resources designed to assist seniors throughout their retirement. MemoryCare.com has compiled information on a range of local organizations, programs, and agencies, categorizing them based on the care services they offer for easy browsing.

Area Agency on Aging

The Area Agency on Aging in New Mexico is a crucial asset for retired individuals, providing advice on financial assistance, home-based care, and planning for extended care. It also connects seniors and their caregivers with local resources.

Cash Assistance Programs

Financial assistance initiatives exist in New Mexico to help seniors with low income sustain their home living. These initiatives provide tax reductions, discounts on crucial services, and aid for home temperature regulation costs.

Financial Assistance for Senior Care and Senior Living

Elderly individuals in New Mexico, living independently or in elderly care homes, can avail of numerous local financial support opportunities. These aid options help reduce in-home or long-term care costs and connect them to valuable community resources.

Food Assistance Programs

In New Mexico, numerous community programs focus on enhancing the health of seniors via proper diet. These initiatives provide meal delivery, shared meals, and food bank services, guaranteeing that older citizens can obtain reasonably priced, healthy food.

Free Used Medical Equipment

In New Mexico, several organizations are tackling the high cost of new medical devices. They collect lightly used equipment such as wheelchairs, ramps, and walkers, distributing them to local elderly and those requiring assistance.

Health Insurance & Prescription Drug Coverage for Seniors

Elderly residents of New Mexico with certain income brackets have access to local aid for prescription medication expenses. They might also be eligible for health coverage and other programs providing complimentary or reduced-cost healthcare services.

Home Repair and Modifications

In New Mexico, a variety of programs exist to support seniors and those with disabilities in funding home improvements and repairs. These initiatives, providing grants or loans, feature different eligibility criteria tailored for retired individuals.

Social Security Offices

In New Mexico, Social Security offices are crucial resources for the elderly and those with disabilities. They provide advice on retirement perks, disability benefits, and additional security income.

Tax Assistance

In New Mexico, a variety of tax assistance options exist for seniors and people with disabilities. These encompass possible medical cost exemptions, property tax cuts, and other tax alleviation measures.

Utility & Energy Bill Assistance

In New Mexico, there are establishments ready to assist seniors with limited income facing challenges with home upkeep expenses, such as energy and utility bills. Emergency financial support might be available for individuals threatened with utility disconnection due to outstanding payments.

Veteran's Services

In New Mexico, retired military personnel can find essential support through local veteran services. These organizations help veterans access their deserved benefits and offer advice on a variety of issues.

Note: The following information was compiled and most recently updated on 2/10/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.